Billing for ophthalmology is not general billing with a different code set. Medical versus routine vision coding, and testing services with their own frequency limits.
Two entirely separate benefit structures — medical and vision — that patients routinely assume are one.
At a glance
What drives the coding
Medical versus routine vision coding, and testing services with their own frequency limits.
What drives the payer behavior
Two entirely separate benefit structures — medical and vision — that patients routinely assume are one.
Coding
Assigned by certified coders from your documentation.
Reporting
Denials segmented by reason, payer, and provider.
Where ophthalmology claims actually fail
- Routine vision billed to the medical plan
- Diagnostic testing exceeding frequency limits
- Post-operative period services billed separately
How we work it
We code from what your record documents and query you when it does not support a code, which in ophthalmology is where most of the avoidable exposure sits.
Denials are worked by cause rather than in queue order, so the same failure stops recurring instead of being re-worked every month.
We keep the books. You run the business.
Categorization, reconciliation, month-end close, and clean financial statements — with nothing left for you to chase.
View pricingHow It Works
Review
We look at your current ophthalmology denials and aging.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes reported monthly, segmented by payer.
Ophthalmology — Frequently Asked Questions
Do you have coders who know ophthalmology?
+
Yes. All coding is performed by certified coders, and specialty assignment is deliberate — medical versus routine vision coding, and testing services with their own frequency limits.
Do you guarantee we will collect more?
+
No, and nobody honestly can. Payment is decided by the payer. What we commit to is the process and the six numbers we report, which you can check against your own system.
Ready for books you can actually trust?
Book a free consultation and we will tell you what your books need and what it costs.
- Done-for-you
- Solo or group
- Nationwide
Book Online
Share your details and preferred availability.